Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 350.00 - Rates for Home Health Services
Section 350.02 - General Definitions

Current through Register 1531, September 27, 2024

As used in 101 CMR 350.00, unless the context requires otherwise, terms have the meanings set forth in 101 CMR 350.02.

Activities of Daily Living (ADL). Activities related to personal care, specifically bathing, grooming, dressing, toileting/continence, transferring/ambulation, and eating.

ADL Support Visit. A home visit performed by an eligible provider to a member for assistance with ADLs when the member is not receiving concurrent home health skilled nursing or therapy services.

Eligible Provider. An organization certified as a provider of services under the Medicare Health Insurance Program for the Aged (Title XVIII) and that meets such conditions of participation as have been or may be adopted by a governmental unit purchasing home health services.

EOHHS. The Executive Office of Health and Human Services established under M.G.L. c. 6A.

Governmental Unit. The Commonwealth of Massachusetts and any department, agency, board, commission, division, or political subdivision of the Commonwealth.

Home Health Agency. An organization that meets the requirements of 130 CMR 403.000: Home Health Agency to provide home health services.

Home Health Aide Service. The provision of personal care and other health-related services in the home, as described in 130 CMR 403.416(B) through (D) by a home health aide as defined in 130 CMR 403.402: Home Health Aide.

Home Health Services. Skilled nursing visits, physical therapy, occupational therapy, speech therapy, and home health aide services provided in the individual's home.

Home Visit. A morbidity visit rendered in the home by a qualified employee of a home health agency.

Medication Administration Visit. A skilled nursing visit for the purpose of administration of medications when the member is unable to perform the task due to impaired physical, cognitive, behavioral, and/or emotional issues; no able caregiver is present; or the member has a history of failed medication compliance resulting in a documented exacerbation of the member's condition, and/or the task including the route of administration of medication requires a licensed nurse to provide the service. A medication administration visit may include administration of oral, intramuscular, and/or subcutaneous medication or administration of medications other than oral, intramuscular and/or subcutaneous medication, but does not include intravenous administration.

Nursing Services. Services as defined in 130 CMR 403.402: Nursing Services and described at 130 CMR 403.415: Nursing Services.

Occupational Therapy. Services as defined in 130 CMR 403.402: Occupational Therapy provided by an occupational therapist as defined in 130 CMR 403.402: Occupational Therapist and occupational therapy assistant as defined in 130 CMR 403.402: Occupational Therapy Assistant.

Office Visit. A health promotion or therapeutic visit rendered in a home health agency's office.

Physical Therapy. Services as defined in 130 CMR 403.402: Physical Therapy provided by a physical therapist or physical therapy assistant as defined in 130 CMR 403.402: Definitions.

Publicly Aided Individual. A person who receives health care and services for which a governmental unit is in whole or part liable under a statutory program.

Reasonable Costs. Those reasonable and necessary costs incurred by an eligible provider of home health services, subject to the requirements and limitations of 101 CMR 350.00. In determining the reasonableness of costs, EOHHS may consider the particular services offered, the introduction of efficiency measures, the requirements for staffing, and the costs of providing comparable service.

Security/Escorts. The provision of security services to direct care personnel in the performance of a reimbursable home health visit.

Speech/Language Therapy. Services as defined in 130 CMR 403.402: Speech/Language Therapy provided by a qualified speech/language therapist (speech/language pathologist) as defined in 130 CMR 403.402: Speech/Language Therapist (Speech/Language Pathologist).

Therapeutic or Morbidity Home Visit. A home visit rendered by an eligible provider to an individual and/or family for the purpose of treating one or more diagnosed illnesses or disabilities.

Visit. A visit as defined in 130 CMR 403.402: Visit that is up to eight 15-minute units.

Weekday. The hours from 7:00 A.M. to 3:00 P.M., Monday through Friday.

Weekend and Nights.